Your Right to Know

After months of debates, delays and political hand-wringing, Ohio will expand Medicaid to cover
275,000 low-income residents.

But as soon as today, a conservative organization, possibly joined by House Republicans, may
file a lawsuit to invalidate the vote yesterday by the seven-member Controlling Board, which
approved by a 5-2 bipartisan vote a request to accept $2.56 billion in federal money for the
expansion through June 2015.

Meanwhile, Senate Republicans said they immediately plan to offer a $400 million income-tax cut,
amounting to about 4 percent, using money largely from Ohio hospitals that will receive additional
federal money in the expansion.

Supporters in the standing-room-only hearing room — another 100 watched on monitors from the
atrium — cheered as Ohio became the 25th state to approve Medicaid expansion under the federal
Affordable Care Act. Starting Jan. 1, mostly childless adults earning up to 138 percent of the
federal poverty level — about $16,000 for a one-person household — can receive health care under
the state-federal program.

“This is the day we’ve been waiting for and working to for a long time,” said Gayle Channing
Tenenbaum, director of policy and government affairs for the Public Children Services Association
of Ohio.

Unable to get the full Republican-controlled legislature to go along with expansion, either as
part of the two-year budget or as separate legislation, the Kasich administration instead got
federal approval on its own and went to the Controlling Board to approve the federal funding.

The expansion will be 100 percent federally funded for three years before dropping to 90
percent, bringing $13 billion to Ohio over seven years.

After much speculation and drama over which of the four Republicans on the board would provide
the needed vote to approve the request, Speaker William G. Batchelder, R-Medina, replaced both of
his GOP members yesterday. One addition was Rep. Ross McGregor of Springfield, a moderate,
term-limited Republican who already had indicated he would vote yes.

Sen. Chris Widener, R-Springfield, also voted for it, citing struggles faced by those left
uncovered.

“These people are not wanting to be in Medicaid their entire lives,” he said. “They are working
Ohioans that need help for a little bit of time. It’s clear to me this gap left by (Obamacare) is
best dealt with by putting them in the Medicaid system.”

The governor’s appointee who leads the Controlling Board, Randy Cole, and the two Democrats,
Rep. Chris Redfern of Port Clinton and Sen. Tom Sawyer of Akron, also voted for the request.

GOP legislative leaders, under pressure from conservatives and tea party-affiliated groups to
oppose the expansion, put the onus on Kasich.

“This is not a vote in favor of or opposition to the federal health-care law,” Batchelder said. “
The decision to change Medicaid eligibility has already been made by the governor’s
administration."

Senate President Keith Faber of Celina said he opposed expansion, “but the governor made this
decision without legislative approval.” In addition to a tax cut, Faber said the Senate will look
to limit Controlling Board power in the future.

Both House and Senate Republican leaders say they want to move soon on Medicaid reform bills
aimed at slowing cost growth and helping recipients get off the program.

Medicaid expansion “will be particularly helpful to the over 60,000 individuals battling
addiction and 55,000 Ohioans living with mental illness who will now have access to life-saving
physical and behavioral health-care services,” said Cheri L. Walter, of the Ohio Association of
County Behavioral Health Authorities.

Likewise, she said, expansion will help fight Ohio’s opiate epidemic, where people “have
historically been unable to access services due to a lack of coverage.”

The Ohio Liberty Coalition of tea party sympathizers tweeted: “Amazed here at the amount of
hubris displayed by the Kasich administration to bypass both the people and the legislature.”

Conservative lawyer Maurice Thompson of the 1851 Center for Constitutional Law said he will file
a lawsuit as soon as today, and unnamed House Republican lawmakers would “most likely” join
him.

The lawsuit will charge that the Controlling Board vote did not represent the “legislative
intent” of the General Assembly.

Last week, 39 legislators signed a formal letter of protest over Kasich’s move, including
Batchelder. The letter was drafted by GOP Reps. Lou Terhar of Cincinnati and Jim Butler of
Oakwood.

During his testimony before the Controlling Board, Kasich cabinet member Greg Moody said, “We
believe this action is appropriate. ...We were very careful to understand the nature of the
authority that’s involved.”